School phy

samyjm13

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I put a questioned out there for cpt code for school physicals, and never got an answer, if anyone could help on this, would appreciate it.

Thanks
 

dballard2004

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I'll offer my opinion here....

If the school physical is performed as part of the child's annual wellness exam, or the exam meets the criteria for a wellness exam, then I agree you would report the age-appropriate preventative medicine E/M code. You would not report the office/outpatient E/M codes of 99201-99215 because these are problem-oriented visits, and usually with a school physicial, the patient is asymptomatic.

If the school physicial does not meet the criteria for a preventative medicine exam or is performed outside of the patient's annual wellness exam, you would report 99499 (unlisted E/M). It has been my experience that most insurance won't cover school physicals, so you may have to make them a cash visit.

Hope this helps.
 
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